Amid Opioid Crisis, Insurers Restrict Pricey, Less Addictive Painkillers

By Katie Thomas and Charles Ornstein, The New York Times and ProPublica

18 September 17

Drug companies and doctors have been accused of fueling the opioid crisis, but some question whether insurers have played a role, too.

t a time when the United States is in the grip of an opioid epidemic, many insurers are limiting access to pain medications that carry a lower risk of addiction or dependence, even as they provide comparatively easy access to generic opioid medications.

The reason, experts say: Opioid drugs are generally cheap while safer alternatives are often more expensive.

Drugmakers, pharmaceutical distributors, pharmacies and doctors have come under intense scrutiny in recent years, but the role that insurers — and the pharmacy benefit managers that run their drug plans — have played in the opioid crisis has received less attention. That may be changing, however. The New York State attorney general’s office sent letters last week to the three largest pharmacy benefit managers — CVS Caremark, Express Scripts and OptumRx — asking how they were addressing the crisis.

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